jwester

OP, define aggressive and better yet , do an in person assessment . Chemical restraints aren't a safe or ethical treatment for dementia . Perhaps the patient is acting aggressive towards staff because said patient has sundowners tendencies and doesn't want to go to bed at 8 pm so that staff can watch TV (seen it). We had a practitioner who doled out trazadone for aggression to almost every resident . Guess what ? They still wandered in the evening and were not too happy with staff who tried to keep them in their beds . Hip fractures galore from being sedated . Don't let staff bully you into writing scripts so that grandma stays in bed until am shift arrives . CNA's will pressure the RN or med nurse , and the med nurse will pressure you . If a script is warranted , carry on . But if staff is wanting patients sedated on benzos , Perhaps it's time to have a meeting and educate staff about dementia . Redirection and understanding dementia (and evening wandering ) is far more therapeutic than unnecessarily drugging someone . You're just asking for falls , incident reports , broken bones , etc . Even worse if the patient uses an assistive device . Cartwheeling over a walker or cane due to being sedated isn't an option .

It's a definite challenge when an NP cannot spell or write with proper grammar .

Are you already working as a PsychNP ? There are part time and travel opportunities available , although pay rate will vary . As mentioned , there won't be any counseling in your role . NP's make referrals and focus on prescribing . The medication management is a joke . Over burdened with too many patients to see and if there are frequent med changes , questionable lab values or frequent hospital admissions , you may be better off having a nurse do follow up calls with your patients to help manage the meds . The RN obviously can't write / change meds , but a sharp one with excellent experience and excellent pharmacology background to monitor and report side effects will be a big help .

Wellness assessments and risk assessments are very simple template forms usually used by insurance companies . Medical records of the patient can be reviewed to compare accuracy but aside from recording medications , which may also be inaccurate if meds have been changed or DC'd , this is a very simple home based subjective assessment . As reported by your patient / family . Any training will most likely center on using the company's laptop . Most of the time , vitals are measured and the assessment can include wound inspection or other visuals , but this is not the same as an in office physical . It's a questionnaire with medical terminology . And I reiterate , it's subjective report from the patient and or family . Medication checks / reconciliation or DME , LOC assessments , etc are also commonly inaccurate unless you're lucky enough to speak with a knowledgeable staff member from the discharge team who can verify discharge date , physician , condition, medications , etc . RN's and social workers have been performing these for years ( for junk pay ) . Think of it as an intake eval without much to validate what the patient reports . I'm rather surprised the role is being offered to NP's when RN's can complete them and full timers are very time efficient (and well versed in the type of problems that will crop up when attempting to coordinate care . I'm not here to discourage NP's but use the extra school to make better money and perhaps stick with office / hospital physicals that are thorough and can include diagnostics and labs . HRA's can and have been delegated out to RN's and LPN's . For about 30/HR . Unfortunately , incompetent staff completes the assessments as well and they are a sloppy embarrassment . We used to audit the forms and notes and many times it appeared as if the home "assssor" was checking off boxes and rushing through it . The good staff members completed to the best of their abilities considering it was largely subjective and there were a lot of no shows . But .. best of luck if NP's want to do such simple data work .

An RN can complete a Risk Assessment . Are you signing 1147's or completing prior authorizations ? How detailed is the home assessment ? If it's simply data collecting and a visual physical exam with no labs , why are NP's completing what is a rather basic template built assessment ?